Individual provider Active NPI

Mikel Matto, M.D.

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1003107699
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
207172 Issued in OR
Practice address
2214 Lloyd Ctr
Portland, OR 97232-1311
Phone
(503) 494-4222
Fax
(503) 494-6143
NPI assigned
Apr 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A122499 CA
Psychiatry Physician 2084P0800X 61207081 WA
Psychiatry Physician 2084P0800X 207172 OR Primary

Addresses

Primary practice location

2214 Lloyd Ctr
Portland, OR 97232-1311

Mailing address

1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537
Phone (866) 617-6855

Other practice location 1

4001 Main St Ste 318
Vancouver, WA 98663-1888
Phone (039) 465-4315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322002322 OR Practitioner - Psychiatry 2769783869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Davis School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

2525 SW 1St Ave
Portland, OR 97201-4753

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
122499CAMDMarriage & Family Therapist
A122499CAMDPsychiatry Physician
207172ORMDPsychiatry Physician
61207081WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 14, 2022 Accepting new patients
University Professional Services CurrentSince Oct 1, 2022 Accepting new patients
Legacy Emanuel Hospital & Health Center Psychiatry CurrentSince Mar 14, 2022 Accepting new patients
University Professional Services CurrentSince Oct 1, 2022 Accepting new patients
University Professional Services Current Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2214 Lloyd Ctr
Portland, OR 97232
Phone (503) 494-4222

1400 SW 5th Ave
Ste 500
Portland, OR 97201

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

Interoperability endpoints

  • Direct secure messaging: mmatto151183@direct.ohsu.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1003107699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "866-617-6855",
            "fax_number": "503-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 LLOYD CTR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321311",
            "telephone_number": "503-494-4222",
            "fax_number": "503-494-6143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Main St Ste 318",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986631888",
            "country_code": "US",
            "telephone_number": "039-465-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTO",
        "first_name": "MIKEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-29",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A122499",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "61207081",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "207172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.